Posted
by
ScuttleMonkeyon Wednesday September 28, 2005 @03:02PM
from the but-doctor-this-patient-doesn't-have-an-off-button dept.

skeletor935 writes "Due to the increase in the number of medical students in Mexico, medical schools have turned to the use of robotic patients to assist in training." From the article: "The robots are dummies complete with mechanical organs, synthetic blood and mechanical breathing systems."

The robot was used for instruction for surgeons and anaesthesiologists.

"Excuse me, Doctor, but I think you meant to clamp here, and clip there. There you go, now you got it. Oh, by the way, tell the anaesthesiologist that I could really use some more anaethesia. Other than that, doing good."

Learn about the evolution of surgery including the development of "minimally invasive techniques" and the impact of performing those operations using robotics. Watch how "Zeus" a state-of-the-art robot, performs an operation under the guidance and direction of a UW s

Actually, the potential applications of such mechanical organs and other simil-organic stuff is very important for transplants on (living) human beings. The more these robots are made similar to the "real thing" (so that training doctors know *exactly* what happens when they "miss") the more their parts will be near to be useful to supplant defective parts of humans.

Of course, if there's a risk in there it's that the "mechanical organs" could be as bad as the real ones:)

MSpatient: Used for a wide variety of easy operations. Unfortunately, sometimes the patient will randomly die without cause, causing the students uneeded frustration. It also has the nasty habit of simulating diseases it wasn't supposed to in the first place and occasionally making up new ones.

LinuxPatient: Only useful for the simulation of a few very difficult operations. The patient responds exactly how it should under the given treatment. Unfortunatley,

A robot may not injure a human or, through inaction, allow a human to come to harm, even if that human has jabbed him repeatedly in the arm with a practice needle

a robot must obey orders given to it by a human, except where it would conflict with the first law, and except when that order is "Hey, get better quick before the professor comes back, and then say I did it!"

A robot must protect itself, as long as that protection doesn't violate either the first or second law. Hmmm, this one sort of limits how many robots will be in the ICU in the first place eh?

A robot must protect itself, as long as that protection doesn't violate either the first or second law. Hmmm, this one sort of limits how many robots will be in the ICU in the first place eh?

A robot must deliberately place itself in harms way at least once a month as long as the harm does not violate the first or second law, and the harm is limited to that which can be fixed by a medical intern.

That's a good question, indeed. As for why they are using politicians in the first place, though - that I can answer. Check out this recent annoucement from the National Institute of Health:

The National Institute of Health have announced that they will no longer be using rats for medical experimentation. In their place, they will use politicians. They have given three reasons for this decision:
1. There are now more politicians than there are

We could only wish our medical students in the US needed robots as test patients. Unfortunately there is a monopoly on doctors, and the problem will only get worse.The AMA is a lobbying organization with complete control [lewrockwell.com] (last paragraph) over the number of doctors.

Mexico has not enacted these same licensing restrictions, and surely allows for more doctors who can be used outside the country. Mexicans are well known to send a great amount of income back home.

When I was an undergrad, one of my professors told me that 20-30 years ago the army tried to institute a program whereby they would give you schooling to be a doctor in return for a extended stint in the army (sorry, I don't have a link to verify). But the upshot was that the AMA lobbied against it, so it didn't pass. If it had passed, then there would be quite few more doctors than there are now, which presumably would give us cheaper medical care.

I don't think it's the doctors that drive up the cost of healthcare. It's the entire structure, the monstrosity, known as HEALTHCARE that makes medical care so expensive. This encompasses everything from the cost of getting into and through medical school to insurance companies, hospitals, pharmaceutical companies, lawyers, and the industries that support them. such a tangled web we weave...

For 150 years they've lobbied for every item that drives up medical costs. I came across this article [lewrockwell.com] about 7 years ago, my first LRC article ever:) Great history of the nemesis I feel is worse than the RIAA, MPAA and DoD combined.

Aye, the problem with US healthcare isn't the doctors or AMA, its the insanely high number of middlemen making huge profits. Especially insurance organizations- they take a large cut out of the middle, and actually produce nothing of value. Thats why we need national health care- cut out the middle men entirely, and you could see prices cut in half, with no difference in service than you see from an HMO or PPO today.

I'm not sure exactly what program you are talking about. But there is currently a program, though both the Army and the Navy, that will pay for your medical school in exchange for your service. It works out that you serve one year of active duty for every year they pay, with a minimum of three years. They not only cover your tuition, but they also pay for your books and supplies, and give you a living stipend. So while it might not be the exact program you describe, it seems pretty close.

Mexico has not enacted these same licensing restrictions, and surely allows for more doctors who can be used outside the country.

This isn't an even comparison. Health care in the US is privatized for the most part, with only a small percentage of health care facilities and professionals dedicated to socialized work for lower-income patients. In Mexico there are at least 3 large entities providing socialized medicine for various types of employees:

Please allow I, C3PO, to be the first to welcome our new Mexican medical overlords. I'm sure I can be of great assitance to you as besides Spanish I am fluent in over six million forms of communication.

Since we're discussing medicine in México, I would like to chip in my two pesos about the experience of receiving medical care in México versus getting care in the US; I got care in both countries in the last month or so.

In México, the care I received was excellent. After being sick for three days with Montezuma's Revenge, my friend's cousin, who happens to be a doctor came by, asked me a number of questions in Spanish, looked me over, and gave me some antibiotics to stop the sickness along with a couple other medicines to help me. The examination and care was done very well. Total cost: $25 for house call doctor visit, $5 for medicines. By the evening, I felt great again.

When I came back to the US, I saw a doctor through Kaiser. The nurse treated me like a mechanical doll instead of a person. The doctor was good, but only very briefly examined me before telling me I had a virus and that there was basically nothing they could do. The cost for this care $25 co-pay, plus $200 a month to be on insurance to get this kind of care.

In México, they don't have to worry about malpractice lawsuits. A person can be a full-up doctor at 26 years of age (such as the doctor I saw down there). Here, one has to be about 30 before they can be a doctor; they spend more time in medical school and less time getting real-world hands-on experience. Most drugs can be obtained without prescription (the exception being addictive drugs like valium and what not)--this causes people to get antibiotics when they have viruses, unfortunatly.

Which one is better? I prefer the Mexican system; less HMO BS and more real care.

To counter your good experience in Mexico, I had a friend who got hurt in Cancun Mexico this past summer. He got a couple of cheap stitches to stop the bleeding, and a shot of some pain-killer (that he said didn't work anyway) for $450 CASH. He got told that for $25 more, he can be assured he got a clean needle for the shot.

Real care? I dunno, guess its a matter of opinion, but I like to know that if I'm getting a shot, I'm getting a clean needle...

Most drugs can be obtained without prescription (the exception being addictive drugs like valium and what not)--this causes people to get antibiotics when they have viruses, unfortunatly.
Which one is better? I prefer the Mexican system; less HMO BS and more real care.

Yeah, I'd prefer the American system because giving out antibiotics when you probably didn't even need them to start with is stupid, idiotic, and quite risky for everyone else. Eventually, those drugs will be rendered useless.

Our medical industry is in the shitter due to the AMA restricting doctor numbers (driving costs up and demand up) and the HMO Act of Congress. Both of these statist mechanism force costs up and quality/safety down.

The freer a business market is to accept competition, the better cost and safety gets.

Do you really think that the AMA is restricting doctor numbers? If so, could you please provide a reference? I would think that doctor numbers are limited more by the following:1) High barriers to entry including:
a) Large education costs (~$54k a year (tuition + living expenses) for a top private school)
b) Years and years and years of training
c) Extensive (and continuous) licensing requirements (from the government, not

The link further in this thread is a good overview. Here's some more information:The wiki [wikipedia.org] while in dispute, points to others who acknowledge that the AMA runs State Medical Boards. If you query your state's SMB on how they categorize medical schools, they'll acknowledge using the AMA's grading system.

The AMA is a terrible organization, already convicted of violating the Sherman anti-trust act. They've even manipulated dieticians (my step mother), USDA and FDA guidelines and numerous studies regarding new

No, but I believe service and price do. Students get wealthier. As the article [lewrockwell.com] I point to shows, you don't see many poor bad doctors but you see many lawyers fail. The AMA keeps bad doctors wealthy, the ABA doesn't wield much power.

Poor people in mexico have to go to the IMSS (a hospital system dedicated exclusively to Social Security). The service is awful, the medicines you have to buy them yourself, and most of the money is leeched for retired workers. There was a case where a woman had to buy the oxygen for her mother because there weren't O2 tanks at the hospital:-/

The management system is so bad that it needs a billionaire rescue before it collapses. And you thought the american social security was hard to maintain. Heh.

The article is, of course, extremely light on details. The only difference between this and "SimMan" which has been in use for years and years seems to be the inclusion "artificial blood," whatever that means.

Also, this is pretty funny: "I would feel nervous if this was (a) real patient," said Mendoza after drawing blood from a plastic arm.

"With this (dummy patient) I can practice many times."

Because jabbing a needle into plastic is just like jabbing a needle into human flesh.

The sorts of simulators are very useful for simulating emergency situations, but aren't really suitable for things like surgery. It's nice to have the motions of checking pulses, barking commands for IVs and epinephrine, and setting up a defibrillator down pat for when a patient is crashing before your very eyes. Since there is very little actual manipulation of the patient, this is exactly for what we use SimMan (cardiac arrhythmias, emergency intubations, and the like). The monitor values (projected on a screen for all to see) are changed by a preceptor as you do things like move from nonrebreathing masks to bag mask ventilation or add a second IV. I just don't see how this would be used to do surgical simulation at all.

well, looks like the only difference between this and our SimMan is the pupillary response and the blinking. A favorite of our CCM profs is to press a button and have the larynx clamp down right after extubation:)

and on that page you linked to, there's a description of the surgical simulation, which is just for endoscopy. i played with that about 10 years ago at a science center. fun and useful, but certainly nothing new.

But a vast improvement over what the medical industry had back in the 60's and 70's. They had simple manikins that had rubber ateries and veins for students to try to draw blood or start IV's. Other manikins had electricial impulse generators that simulate any kind of heart rythium that the tester wishes.On the downside, these ancient units required large amounts of support gear and broke down frequently. Not to mention the COST! At the time of introduction, a typical patient simulator ran nearly a million

how common is the use of these 20-few robots in the university?
-is it only the first years that are using them, or upper classmen as well?
-What percentage of their med school prep classes will involve real live human beings?
---->I know from the article that they are using robots, but not how they are using them

I also find it hard to believe that they have more doctors than needy patients who need medical care or hospitals. That they'd have to "resort" to robots because there are too many doctors. Wh

Poor people don't deserve less quality care, but the reality is that right now they have minimal to no care, especially in rural areas.
I volunteered in a 3rd world country for a few months. When i told the hospital that i had my Bachelor's degree in science/ psychology, they were ready and willing to not only let me see patients as a Psychologist, but also prescribe medicine. In the end I proved useful after some on the job training.. if i can do it, a medical student certainly could be utilized. Why wa

i agree. some medical care is better than none, especially in the rural areas of 2nd and 3rd world countries.
i volunteered in a 3rd world country for a few months in the government run medical system. once i told them i had my bachelor's degree in science/psychology, they were ready to let me have my own practice and prescribe medicine! after a few weeks of on the job training, i actually proved useful. i can't imagine they wouldn't be able to utilize medical students, and at the same time enable those

I'm so glad to see that a country that can't afford to even provide good living conditions for its citizens can afford to spend 1.3 million on a robotic hospital. I'm sure that's money better spent than on, say, roads and sanitation.

If the Mexican government spent more money on their infrastructure and less on "pie in the sky" robotic hospitals, maybe their citizens would stay there instead of border jumping.

LOL, have you ever been outside the city where you live? have you been to mexico? you have no idea of what you are saying. Most mexicans go "border jumping" because luickily there are amny LAZY us citizens that will pay very well for many basic chores

In other news, a robot has filed suit against the Mexican Medical Board. The robot has accused a medical student of removing its central I/O system instead of the rubber tumor that was scheduled for removal. There are also complaints of robotic harrassment from other medical lab droids...

You would think that with the limited resources and high level of unemployment in Mexico they would have figured out by now that they could save a lot of the money they are spending on robotics by just substituting volunteers to be real patients.

The robots won't help train doctors in good bedside presence and patient communication. "Its inoperable, i'm sorry - You have a month to live, at most."verses "This unit is hosed, the permission bits are screwed up and its down to 18% - i'm sorry."

I listened to a story [npr.org] about this on NPR in the Spring. It was very interesting. The simulator will give a blood flow response, etc. It's not perfect - no blood vessels, rubbery skin,... but the simulator still feels pretty much like it does in real life when you feel it through surgical gloves. While prepping each simulator for a new trainee is expensive, it's possible to make mistakes (and learn from them) on a dummy without actually killing anyone.

The audio story has Nell Boyce running through a surgical procedure on an actual dummy. Her reaction was that it feels very much like a live person.

We have currently have two of these at my medical school. I'm a first year medical student (started in August), so my exposure is limited, but I've already had one "human patient simulator" encounter. Although it was fascinating froma technological standpoint, the usefulness seems to be pretty limited. My school is working hard to implement it into the curriculum, but it's not as practical as they seem.The first issue that arises is that you only have first and second year students on campus (usually). Man

This is a pretty poor news story. This has been going on for years. The manikin shown looks like it is a Laerdal [laerdal.com] one. These types of manikins are very effective for teaching certain things. At Fort Hood in Texas the US Army has hundreds of them to train their medics.

In addition to manikin 'robots' there are also VR simulators that are used for training. On the whole these are not as effective but are good for some procedures. The major manufacturer of these is Immersion [immersion.com].

I think the US should follow suit. Otherwise we risk losing out to Mexico as the market leader in the burgeoning field cybernetic medical care. I know we'll all feel very sheepish when Astroboy is going to Guadalajara for his dialysis....

For some high risk procesures, these simulators are nice, but there is no substitue for working on real live people. Even if the number of Mexican medical school docs has increase, I'm sure tehre are still tons of people in Mexico who recieve no medical care or are on wait lists months long to get live preserving treatment. Why not at least give them a chance at timely treatment, even if it does mean being a learning tool.

There was (is) an Amiga game which I think is called Life & Death, and you as the doctor had to perform a surgery on the patient. However, the only thing I remember about the game is the rapidly swelling pools of blood, the quickly rising heartbeat of the patient... and in the end the patient opened his eyes and let out a scream. Of course, the scream rattled the speaker on my little tv* and I almost got a heart attack.* Back in the old days, we used tv's - not monitors. And we had to made do with a fl

Here's a link to a recent TV story done by Discover Channel Canada. See the article "Making a smarter dummy."
http://www.exn.ca/dailyplanet/view.asp?date=9/27/2 005 [www.exn.ca]
The only inaccuracy in the story is that the patient simulators are priced from ~$30K to 200K.
And for the record (and a shameless plug), the manufacturer in Sarasota is METI.
http://www.meti.com/ [meti.com]